St. Marianna University School of Medicine, Division of Metabolism and Endocrinology, Department of Internal Medicine , 2-16-1, Sugao, Miyamae-ku, Kawasaki, 216-8511 , Japan
Expert Opin Pharmacother. 2013 Dec;14(17):2315-22. doi: 10.1517/14656566.2013.842554. Epub 2013 Sep 30.
The postprandial glucose (PPG) level is reduced by α-GIs, glinides and DPP4Is through different pharmacological actions. The aim of this study was to compare the effect of sitagliptin (S) versus that of the combination of mitiglinide and voglibose (M+V) on markers of glycemic control.
A randomized cross-over trial was performed in 20 patients with drug-naïve type 2 diabetes. The patients were randomized to receive S (50 mg/day) or M+V (1 tablet 3 times daily). Treatment was continued for 8 weeks, after which they were switched to the other regimen and treated for another 8 weeks. At baseline, after the first regimen, and after the second regimen, a meal test was performed.
The markers of glycemic control were examined.
Reduction of glucose excursion was significantly greater with M+V than with S. HbA1c did not change with either regimen. However, 1,5-anhydroglucitol showed a significant increase from baseline with both regimens (7.9 ± 4.3 μg/ml at baseline vs. 10.6 ± 5.5 with S, p < 0.05 and 15.1 ± 6.2 with M+V, p < 0.01). Compared with baseline, glycoalbumin was significantly reduced by M+V, but not S (19.6 ± 2.9% at baseline vs. 17.3 ± 3.8% with M+V, p < 0.05).
M+V achieved better control of PPG excursion than S.
通过不同的药理作用，α-GI、格列奈类和 DPP4I 可降低餐后血糖（PPG）水平。本研究旨在比较西他列汀（S）与米格列醇和伏格列波糖联合（M+V）对血糖控制标志物的影响。
对 20 例初治 2 型糖尿病患者进行随机交叉试验。患者随机接受 S（50mg/天）或 M+V（每日 3 次 1 片）治疗。治疗持续 8 周，然后切换至另一种方案并治疗 8 周。在基线、第一个方案后和第二个方案后进行餐试。
检查血糖控制标志物。
与 S 相比，M+V 显著降低了血糖波动。HbA1c 两种方案均无变化。然而，两种方案均使 1,5-脱水葡萄糖醇（1,5-anhydroglucitol）从基线显著增加（基线时为 7.9±4.3μg/ml，S 组为 10.6±5.5μg/ml，p<0.05，M+V 组为 15.1±6.2μg/ml，p<0.01）。与基线相比，M+V 显著降低了糖基化白蛋白（glycoalbumin），而 S 则没有（基线时为 19.6±2.9%，M+V 组为 17.3±3.8%，p<0.05）。
与 S 相比，M+V 能更好地控制 PPG 波动。
